The New Jersey Department of Health passed a waiver in October of last year that allows ambulances to carry Solu- Cortef, for the purposes of treating an adrenal crisis. As a result, New Jersey ambulances can be better prepared to treat adrenal insufficiency.
This news was brought to NADF by Karen Fountain of the CARES Foundation, who has been helping push state health directors to accept protocols to help treat adrenal insufficient patients during an emergency.
Adrenal insufficient people in New Jersey should contact their local EMS to make them aware of the waiver, and encourage them to carry Solu-Cortef in their ambulances.
The hope is that other states, and eventually the entire country and beyond, will start having their ambulances carry the needed medication to treat adrenal crisis.
- ► 2012 (92)
- ► 2011 (70)
- ► 2010 (32)
- The study objectives were to characterize pharmacokinetics and examine disease control following 6 months dose titration.
- Serial profiling was obtained at baseline (conventional glucocorticoid) and every 2 months.
- Twice-daily Chronocort® was initiated: 20 mg at 2300 h, 10 mg at 0700 h.
- Dose titration was based on clinical status and optimal hormonal ranges (17OHP 300-1200 ng/dL, normal androstenedione (males: 40-150, females: 30-200 ng/dL), with androstenedione prioritized.
- Chronocort® cortisol pharmacokinetic profile was the primary endpoint.
- Secondary endpoints included biomarkers of disease control.
- A total of 16 adults (8 females; age 29 ±13 years) with classic CAH (12 salt-wasting, 4 simple virilizing) participated.
- Conventional therapy varied (5 dexamethasone, 7 prednisone, 4 hydrocortisone).
- Chronocort® cortisol pharmacokinetic profile approximated physiological cortisol secretion.
- Ten patients required Chronocort® dose adjustments (decrease in 8, increase in 2; mean hydrocortisone equivalent dose conventional vs 6 months: 16.1 ± 6.4 vs 14.7 ± 6.4 mg/m2).
- Serial androstenedione levels were in the normal range in 8 (50%) of patients on conventional therapy compared with 12 (75%) on Chronocort® at 6 months.
- The majority of patients on Chronocort® achieved 17O HP levels within the normal range, rather than within the mildly elevated range currently used for management.
- At 6 months, Chronocort® resulted in lower 24-hr (P=0.02), morning (0700-1500; P=0.008), and afternoon (1500-2300; P=0.03) area-under-the-curve androstenedione compared with conventional therapy.
- No serious adverse events occurred.
- Common adverse events were headache, fatigue, early awakening, and anemia.
- Three patients had unexpected carpal tunnel syndrome, which resolved with wrist splints.
- Are you carrying adrenal Cushing’s syndrome without knowing it?(cushieblog.com)
- ARMC5 mutation identified in patients with macronodular adrenal hyperplasia(2minutemedicine.com)
- [PubMed - in process]
- [Available on 2013/12/1]
From Adrenal Insufficiency United
A video about Adrenal Insufficiency and the need for emergency protocols.
An injection which costs about $10 could save a life.
Please help us make sure it's available to all who need it.
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 07/16/2013 Clinical Article
- venous thromboembolism (HR 2.6, 95% CI 1.5-4.7)
- myocardial infarction (HR 3.7, 95% CI 2.4-5.5)
- stroke (HR 2.0, 95% CI 1.3-3.2)
- peptic ulcers (HR 2.0, 95% CI 1.1-3.6)
- fractures (HR 1.4, 95% CI 1.0-1.9)
- infections (HR 4.9, 95% CI 3.7-6.4).
This Survey is to gather information for the Adrenal Insufficiency Awareness Organization's grant project to create educational materials for ER personnel.
The survey is for those of you who have been to the ER during an impending or full blown Adrenal Crisis. (you may fill it out for a child or yourself)
Your help is appreciated!
At the end of the survey you will have the chance to enter for a chance to win an Adrenal Insufficiency Awareness Pin.